National Provider Identifier [NPI]: |
1326007477 |
Last Name Of The Provider |
GRAYBURN |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
621 N HALL ST |
Street Address 2 Of The Provider |
SUITE H030 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752261339 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
964 |
Number Of Medicare Beneficiaries |
597 |
Total Submitted Charge Amount |
251472.98 |
Total Medicare Allowed Amount |
64439.49 |
Total Medicare Payment Amount |
50336.46 |
Total Medicare Standardized Payment Amount |
50812.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
964 |
Number Of Medicare Beneficiaries With Medical Services |
597 |
Total Medical Submitted Charge Amount |
251472.98 |
Total Medical Medicare Allowed Amount |
64439.49 |
Total Medical Medicare Payment Amount |
50336.46 |
Total Medical Medicare Standardized Payment Amount |
50812.26 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
198 |
Number Of Beneficiaries Age Greater 84 |
162 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
457 |
Number Of Black or African American Beneficiaries |
92 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
492 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
41 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1481 |